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General NPI Number Information
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NPI Number | 1013361187
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Entity Type | Organization
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Legal Business Name | STIEL MD LLC
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Dates
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Enumeration Date | 04/14/2016
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Last Update Date | 05/03/2016
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Provider Practice Location Address
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Address Line | 4630 AMBASSADOR CAFFERY PKWY STE 412
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City | LAFAYETTE
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State | LA
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Zip | 70508-6949
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Country | US
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Telephone | 337-993-3933
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Fax |
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Provider Business Mailing Address
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Address Line | 4630 AMBASSADOR CAFFERY PKWY STE 412
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City | LAFAYETTE
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State | LA
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Zip | 70508-6949
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Country | US
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Telephone | 337-993-3933
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ABIGAIL HART
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Credential | MD
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Telephone | 504-858-6386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NW0100X
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Taxonomy Name | Women's Hospital
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License Number | MD.207283
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | MD.207283
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License Number State | LA
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